Utilization Review Lead

<b>At LogistiCare, you have the ability to define your own career journey and enjoy the ride along the way and make possibilities real. Your growth is our objective. Whatever your passion, you’ll have the opportunity to find the career you’re looking for, learn and grow in your role, and make a difference in the lives of others. And you’ll do it alongside colleagues you can count on, in a vibrant work environment, with leadership that puts you first. <br/><br/>Sound like a good career fit? </b>

Atlanta, GA


<strong><a href="http://www.logisticare.com/" target="_blank" rel="noopener noreferrer">Who We Are: Transportation &amp; Integrated Health Services</a><br /></strong>Nation&rsquo;s largest manager of non-emergency medical transportation, provides 69+ million rides annually in 39 states and D.C. Supports integrated health care programs, improving care coordination for members and their corresponding providers and hospital networks.<br /><br /><strong>What We Value Most &ndash; YOU<br /><br />Benefits - The Whole Package&nbsp;</strong><br />Medical, Vision, Dental, Disability, EAP, Legal, Voluntary Life Insurance, Group Life &amp; AD&amp;D, Flexible Spend Account, Paid STD &amp; LTD, Vacation &amp; Holidays<br /><br /><strong>Culture - Why You Want to Come to Work Every Day</strong><br />Casual Dress - Business Casual, Relaxing - Comfy Lounge Areas, Excitement -Themed&nbsp; Luncheons, Great Hours &amp; Set Shifts - (Mon. &ndash; Fri.)<br /><br /><strong>View Featured Positions Below OR Check Out <a href="https://recruiting.adp.com/srccar/public/RTI.home?c=2153313&amp;d=ExternalCareerSite" target="_blank" rel="noopener noreferrer">All&nbsp;Career Journey Opportunities&nbsp;with LogistCare</a></strong> http://www.logisticare.com/

keywords: analysis,support,performance,management,maintain,leadership,analysis,experience,education,skills,work environment,physical demands


Overview: The Utilization Review Lead is responsible for reviewing non-emergency medical transportation requests for stretcher, ambulance and wheelchair transport and works with LogistiCare staff to assist in quality assurance of these trips.
Responsibilities: <p><strong>ESSENTIAL FUNCTIONS</strong></p> <ul> <li>Assist in the review all ambulance and stretcher trips to assure appropriate utilization of resources.</li> <li>Assist with screening all medical documentation and make decisions based on provided information to determine the most efficient and appropriate method of transport or most appropriate medical provider.</li> <li>Assists with standing order recertification.</li> <li>Audits whether provider billed for previously cancelled trips and/or was paid for trips that did not occur.</li> <li>Maintain client confidentiality by compliance to HIPPA guidelines and LogistiCare confidentiality policy.</li> <li>Act as a resource for LogistiCare staff for all medical questions.</li> <li>Provide superior customer service to clients performing the above-mentioned job duties and responsibilities.</li> <li>Responsible for supervision of Utilization Review staff, while maximizing the potential of each employee supervised.</li> <li>Performs other duties and responsibilities as assigned.</li> </ul> <p><strong>SUPERVISORY RESPONSIBILITIES</strong></p> <p>Assists the Utilization Review Manager and Supervisor by monitoring the performance of the Utilization Review Specialist. Carries out lead responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include assisting and assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.</p>
Requirements: <p><strong>POSITION QUALIFICATIONS</strong></p> <p><strong>Competency Statement(s)</strong></p> <p>Accurate - Ability to perform work accurately and thoroughly</p> <p>Communication, Oral - Ability to communicate effectively with others using the spoken word</p> <p>Communication, Written - Ability to communicate in writing clearly and concisely</p> <p>Customer Oriented - Ability to take care of the customers' needs while following company procedures</p> <p>Interpersonal - Ability to get along well with a variety of personalities and individuals</p> <p>Patience - Ability to act calmly under stress and strain, and of not being hasty or impetuous</p> <p>Reliability - The trait of being dependable and trustworthy</p> <p><strong>REQUIREMENTS</strong></p> <p><strong>Education</strong></p> <ul> <li>High School Graduate or General Education Degree (GED).</li> </ul> <p><strong>Experience</strong></p> <ul> <li>At least two years prior experience in a fast-paced, high level customer service-oriented environment strongly preferred.</li> <li>1+ years demonstrated experience in a lead position preferred.</li> <li>Social Services and/or case management, basic medical terminology and/or front or back office medical experience preferred.</li> </ul> <p><strong>SKILLS &amp; ABILITIES</strong></p> <ul> <li>Excellent customer service and phone skills.</li> <li>Must be able to work independently and as a part of a team.</li> <li>Ability to foster and maintain a positive environment.</li> <li>Ability to quickly learn new technology.</li> <li>Must be able to understand and follow complex instructions.</li> <li>Ability to accurately type 35 wpm.</li> <li>Read and write English fluently.</li> <li>Proficient in Microsoft Word, Excel and Outlook and must be able to learn and acquire proficiency in LogistiCare's proprietary software application (s).</li> <li>Bi-lingual a plus.</li> </ul> <p><strong>PHYSICAL DEMANDS</strong></p> <p>The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p> <p>While performing the duties of this Job, the employee is regularly required to talk or hear. The employee is frequently required to use hands to finger, handle, or feel. The employee is occasionally required to stand, walk, reach with hands and arms. Specific vision abilities required by this job include close vision.</p> <p><strong>WORK ENVIRONMENT</strong></p> <p>The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p> <p>Entire work time is conducted in an office environment in a controlled atmosphere building.</p> <p>The noise level in the work environment is usually moderate.</p>